Table Of ContentBeyond Menopause
Beyond Menopause brings to light the unique healthcare needs of postmenopausal
women. It offers women integrative-holistic approaches that bridge the gap between
conventional medicine and systems of holistic healing. Integrative strategies are
highlighted in the context of common health conditions, including anxiety, fatigue,
sleep disturbance, sexual health, weight concerns, bone health, and brain health.
Up-to-date information is provided about the use of hormone therapy during the
menopause transition. Clinical vignettes illustrate how individual women explore
pathways to better health through shared decision-making with their health
practitioners.
Women of postmenopausal age want to remain healthy, vital, and engaged, yet
they are often overlooked in the healthcare system. In this phase of life, women need
to create their own integrative path to wellness. Beyond Menopause shows women
how to prime their voice for self-advocacy and establish collaborative relationships
with their health practitioners. Women are advised to create an adaptable network of
practitioners to accommodate changing needs—their own “web of wellness.”
Beyond Menopause brings a fresh perspective to the mental, physical, and
spiritual elements of holistic living. From the distinct vantage points of medicine
and neuroscience, the authors guide women toward new pathways to optimal health
and well-being.
Beyond Menopause
New Pathways to Holistic Health
Carolyn Torkelson, MD
Catherine Marienau, PhD
First edition published 2023
by CRC Press
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Many of the clinical vignettes are based on women in Dr. Torkelson’s practice; names, details, and any
other personally identifiable information have been changed to protect patient privacy.
All content in this book is for informational and educational purposes only. It is not a substitute for
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ISBN: 978-1-032-16916-3 (hbk)
ISBN: 978-1-032-16496-0 (pbk)
ISBN: 978-1-003-25096-8 (ebk)
DOI: 10.1201/9781003250968
Typeset in Times
by Apex CoVantage, LLC
For our daughters, Erica and Anna
Contents
Foreword ................................................................................................................xiii
Preface......................................................................................................................xv
About the Authors ..................................................................................................xvii
Introduction: Women Coming of Age ....................................................................xxi
Part I Speak Up for Yourself
Chapter 1 Elements of Holistic Integrative Health ...............................................3
Many Terms, Many Perspectives .........................................................3
Women’s Health Goals .........................................................................5
Pillars of Health ...................................................................................6
Chapter 2 Your Voice of Self-Advocacy ...............................................................9
Priming Your Voice ..............................................................................9
Ways of Knowing ...............................................................................10
Emotion .........................................................................................11
Intuition .........................................................................................12
Cognitive Perspectives ...................................................................13
Developing Your Voice ......................................................................14
Silent, Received, and Subjective Knowers ....................................14
Asserting Your Voice .........................................................................15
Procedural Knowers ......................................................................15
Constructed Knowers ....................................................................16
Supportive Self-Advocacy ..................................................................18
Chapter 3 Your Web of Wellness ........................................................................19
Relationship Models of Care ..............................................................19
Immunity to Change...........................................................................21
Wellness Web .....................................................................................23
Part II Expand Your Options
Chapter 4 Postmenopause: Restore Balance .......................................................27
The Menopause Transition ............................................................27
What to Expect ..............................................................................28
vii
viii Contents
Pregnancy No More! .....................................................................29
Estrogens and Progesterone ...........................................................30
Bridging the Gap ................................................................................30
Integrative Strategies ..........................................................................31
Hormone Therapy ..........................................................................31
Bioidentical Hormones .............................................................34
Compounding Pharmacies ........................................................35
When Is Hormone Therapy Recommended? ...........................36
Risks and Benefits of Estrogen-Only Versus Combination
(Estrogen-Progestogen) Therapy ..............................................36
Duration of Hormone Therapy .................................................39
Food, Supplements, and Botanicals ..............................................40
Antioxidants and Cruciferous Vegetables ................................41
What About Soy? ......................................................................42
Why Eat Organic Food? ...........................................................42
Supplements ..............................................................................43
Botanicals .................................................................................45
Are Supplements and Botanicals Safe? ....................................46
Healing Systems ............................................................................47
Traditional Chinese Medicine and Acupuncture ......................47
Yoga ..........................................................................................48
Pathways to Restore Balance ..............................................................50
Catherine’s Pathway ......................................................................50
Chapter 5 Sexual Health: Energize Flow ............................................................53
Sex As We Age ..............................................................................53
Bridging the Gap ................................................................................54
Integrative Strategies ..........................................................................54
Contributing Factors and Conditions .............................................54
Nourishment ..................................................................................59
Communication—Let’s Talk Sex! ............................................59
Sex Toys and Self-Pleasuring ...................................................59
Hormone Options .....................................................................60
Pelvic Floor Physical Therapy ..................................................62
Healing Systems ............................................................................63
Acupuncture/Traditional Chinese Medicine ............................63
Yoga ..........................................................................................63
Pathways to Energize Flow ................................................................64
Catherine’s Pathway ......................................................................64
Chapter 6 Sleep: Create Your Rhythm ................................................................67
Understanding Sleep ......................................................................67
Why Is Sleep So Important? ..........................................................68
Bridging the Gap ................................................................................69
Integrative Strategies ..........................................................................69
Contents ix
Hormone Therapy ..........................................................................70
Holistic Sleep Hygiene ..................................................................70
Nourishment ..................................................................................72
Supplements ..............................................................................72
Light Therapy ...........................................................................74
Botanicals .................................................................................74
Cognitive Behavior Therapy-Insomnia (CBT-I) .......................75
Healing Systems ............................................................................76
Ayurvedic Medicine .................................................................76
Yoga ..........................................................................................78
Pathways to Create Your Rhythm ......................................................79
Catherine’s Pathway ......................................................................79
Chapter 7 Anxiety: Calm Your Mind .................................................................81
Situational Versus Generalized Anxiety .......................................81
The Stress Response ......................................................................84
Bridging the Gap ................................................................................85
Integrative Strategies ..........................................................................86
Nourishment ..................................................................................87
Be Present .................................................................................87
Breath Work ..............................................................................87
Meditation and Mindfulness .....................................................88
Prayer ........................................................................................90
Gratitude ...................................................................................90
Sound Therapy ..........................................................................91
Forest Bathing ...........................................................................91
Emotional Freedom Technique .................................................92
Supplements and Botanicals .....................................................93
Food for Mood ..........................................................................94
Healing Systems ............................................................................94
Homeopathy ..............................................................................94
Exercise .........................................................................................96
Pathways to Calm Your Mind ............................................................97
Catherine’s Pathway ......................................................................97
Chapter 8 Fatigue: Enhance Resilience ..............................................................99
Fatigue Is Multifactorial ................................................................99
Bridging the Gap ..............................................................................100
Integrative Strategies ........................................................................100
Nourishment ................................................................................101
Digestive Health......................................................................101
Understanding Your Gut .........................................................102
Healing Your Gut: An Elimination Diet.................................104
Testing the Gut ........................................................................105
Provoking the Gut ...................................................................105
